ABSTRACT

The most distinguishing characteristic of can-cer is its ability to produce metastases. After the lung and liver, the skletal system is the third common site of cancer metastases. Metastatic tumors of the bone are more frequently obser-ved as compared to the primary ones. The spi-ne is the most common site of the skletal metastases. Some tumors are more likely to metasta-size to the bone whereas some of them seldom cause metastatis. More than 80 % of all bone metastases are caused by the metastasize of the breast, lung, prostate, thyroid and kidney tu-mors. Since in most cases the lesions are mul-tiple and the tumor elsewhwre is known, it is not much difficult to diagnose the metastatic malign tumors. The primary tumors are always identifi-ed in advance regarding the 85 % of the metastatic tumors and this certainly facilitates the diagnose. Bone biopsy is the most widely used met-hod in the diagnose of bone tumors. If the history of the patient is known and a metastatic lesion is suspected, biopsy is implemented to verify the diagnose or to obtain tissue for hormonal evalu-ation. The treatment of metastatic spinal disease requires a multidisciplinary approach. This team includes orthopedic surgeons, neurosurgens and medical and radiation oncologists. Patholo-gists play important part on the precise diagno-sis of the tumor. In the last 20 years, even in the cases of bone metastases, success has been achieved in the paliative treatment of cancer. The treatment options available for metastatic spinal disease include radiation therapy, hormonal treatment, chemotherapy and surgery, or most commonly, a combination two or more of these treatment modalities. In this review path-ways of metastatic spinal disease will be studi-ed. Furhermore clinical characteristics, radiologi-cal and pathological diagnosis modalities and differential diagnosis of vertebral metastases will be discussed. The more common metastatic tumors to the spine will be analysed.